This is a comprehensive group of guidelines for imaging patients with demyelinating disease, from an international group of neurologists and radiologists. Suggestions for MR imaging protocols are given for the brain, for surveillance imaging for progressive multifocal leukoencephalopathy, for spinal cord imaging, and for the orbit. Recommendations are also given for what type of material should be included in the report.

The authors report on a cohort of 135 patients with clinically confirmed PRES who received gadolinium-based contrast and evaluate symptoms, etiology, and clinical follow-up. The most common pattern seen was leptomeningeal (17.8*) or leptomeningeal plus cortical (15.6*). No association was found between the presence or pattern of enhancement and any of the variables, which included sex, age, symptoms, blood pressure, and outcome.

The authors performed MR elastography on 10 patients with normal pressure hydrocephalus and 21 age- and sex-matched volunteers. Shear waves with 60-Hz vibration frequency were transmitted to the brain by a pillow-like passive driver. Significant increase in stiffness was observed in the cerebrum, occipital lobe, parietal lobe, and temporal lobe in the NPH group compared with controls.

The authors evaluated complications in a cohort of 45 patients with acutely ruptured aneurysms and 47 with unruptured aneurysms. All were treated with stent-assisted coiling. The permanent complication rate in ruptured aneurysms was 11*. Five of 45 patients had an early rebleed from the treated aneurysm after 3–45 days, and in 4 this rebleed was fatal. Thromboembolic complications occurred in 2 patients with unruptured aneurysms. The authors conclude that the complication rate in ruptured aneurysms was 10 times higher than in unruptured aneurysms.

MRIs from 18 patients with confirmed tubulin mutations and 15 patients with mutations of the genes encoding microtubule-associated proteins were evaluated. The patients with tubulin gene mutations were found to have cortical and subcortical abnormalities such as microcephaly, ventriculomegaly, abnormal gyral and sulcal patterns, small or absent corpus callosum, and a small pons. Fewer subcortical abnormalities were seen in the microtubule-associated protein mutations group.

The authors evaluated patients who underwent oblique interlaminar-approach fluoroscopy-guided lumbar punctures and had cross-sectional imaging of the lumbar spine within 1 year of the lumbar puncture to devise a formula for the appropriate needle length based on BMI. They determined the formula to predict the needle length as Skin-Canal Distance (inches) = 0.077 x BMI + 0.88.